The Bu Qi Gui Inscription and Genesis of the Qin State

The aim of this paper is to define the institutional difference between the aristocratic lineage ruling the service fief of the Western Zhou era and the royal dynasty, reigning over the independent state of the Eastern Zhou era. Different approaches to the genesis of the Qin State are discussed in this paper: the archaeological approach and the “Zhou fiefdom” approach. The first one lacks data directly describing the political process. The problem of the second one is its being based practically on one written source that postdates the events described by 500 years. Therefore, to escape the failures of these methods, the author developed a specific approach that would both deal with political and institutional data on the one side while using data from different sources contemporary to the events in question. Data explicated from Bu Qi gui, Qin gong zhong and Guo ji zi Bai pan – three inscriptions on the bronze vessels dating between IX and VII centuries BC was scrutinized and compared. Two of them were cast by Qin rulers and the third describes the events leading to the creation of the Qin domain. Comparing information of these sources with the data from Sima Qian’s Shi ji allows to determine the precise moment of the Qin domain being transformed into the Qin State and show the institutional innovations that went along with this process. The interior political change of this time is described (i.e. the political crisis of royal inheritance) as well as the exterior change in Qin’s place inside the hierarchy of Zhou domains, particularly the changing relations between the Qin State and the domain of Xiao Guo. This clarified the place that the process of territorial expansion had in this transformation. As a hypothesis, the author built a model presenting the properties distinguishing a service fief and an independent state.

Chosen Moments: a Reflective Journey Illustrating Terminally Ill Patients Choosing the Moment to Die

<p>In this project the author reveals how she is observing and thinking as she cares for people who are dying. She records her reflections and insights and most profoundly reveals that there is life right up to the moment of death, having observed terminally ill patients choosing the precise moment to die. She describes her observations of these moments by using poetry and stories, and explores the implications for her practice as a result. The author presents her reflections using an individualistic, reflective and exploratory perspective which is informed by the work of nursing scholars; Taylor (2000), Benner (1984) and Johnstone (1999). This paper is framed using the metaphors of a journey and a window to indicate the reflective process that the author used to journal her observations in practice over time. This offers a professional and personal record of the author's insights.</p>

Chosen Moments: a Reflective Journey Illustrating Terminally Ill Patients Choosing the Moment to Die

<p>In this project the author reveals how she is observing and thinking as she cares for people who are dying. She records her reflections and insights and most profoundly reveals that there is life right up to the moment of death, having observed terminally ill patients choosing the precise moment to die. She describes her observations of these moments by using poetry and stories, and explores the implications for her practice as a result. The author presents her reflections using an individualistic, reflective and exploratory perspective which is informed by the work of nursing scholars; Taylor (2000), Benner (1984) and Johnstone (1999). This paper is framed using the metaphors of a journey and a window to indicate the reflective process that the author used to journal her observations in practice over time. This offers a professional and personal record of the author's insights.</p>

World Health Organization (WHO) modified partogram fill audit at Matam Communal Medical Center

Objective: To assess the quality of filling of the modified partograph from WHO at CMC Matam. Methods: This was a retrospective descriptive study by clinical audit (AC), carried out on a sample of obstetric records of parturients who gave birth in the maternity unit of the CMC of Matam from January 1 to December 31, 2020, it consisted of a evaluation of the use of the partograph using an audit sheet prepared for this purpose. The random sampling with one step in ten 1/10 was used for the sampling. The parameters related to the performance of the partograph, the progress of labor (hourly rate, fetal state, materno-fetal outcome.) Were evaluated, the traceability of events related to maternal condition, acts and treatments carried out during labor as well as immediate postpartum surveillance data. Data was collected and analyzed using SPSS 20.0 and MS Excel 2010 software. Results: We retained 470 files. The sample represented 87.45% of all parturients whose monitoring required the opening of a partograph during the study period; its behavior met the standard in more than 87, 41% of cases; The hourly rhythm, and the precise moment of each act were notified and respected in 66.60% of the cases, the progress of the work was correctly notified and respected in 28.72% of the cases; the presentation level and the fetal heart rate were reported and respected in 28.78% and 85.96% respectively; the method of entering into labor was notified and complied with in 95.7% of cases. Conclusion: The modified WHO partograph has some shortcomings in relation to its performance, which can be corrected by supportive supervision.

Polymethyl methacrylate cure time in simulated in vivo total knee arthroplasty versus in vitro conditions

Background The present means of confirming the cure of intra-operative polymethyl methacrylate (PMMA) cement are to wait for the remainder cement to harden. To our knowledge, there is no available technique to determine the precise moment of cure for in-vivo cement beneath the tibial tray. This study uses a novel means to determine cement curing time in two environments. One environment represents the operating theater, and the other environment attempts to model cement conditions under the tibial tray during surgery. Materials and methods We determined the temperature-versus-time plot of cement curing using the following two temperature sensors: one in a simulated implanted tibial tray and another in the remainder cement. We performed 55 tests using dental methyl methacrylate cement mixed in the same ratio as the orthopedic cement. To simulate in vivo conditions, a simulated stainless-steel tibial tray was implanted on a cancellous bone substitute (Sawbones, Vashon Island, WA, USA) using standard cement technique and subsequently placed in a 90°F (32.2 °C) circulating water bath. We positioned a temperature sensor in the cement mantel and positioned a second sensor in a portion of the remaining cement. The temperature from both sensors was measured simultaneously, beginning at 5 min after mixing and continuing for 20 min. The first derivative of the temperature provided the precise curing time for each condition. We analyzed the results of 55 repeated experiments with an independent samples t-test. Results With the described technique, we were able to accurately determine the moment of cure of the cement beneath the simulated tray. There was a mean difference between cure time of 5 min and 26 s (p value < 0.001) between the two conditions. Conclusions We validated that our technique was successful in determining the precise time to cure in two different environments. Level of evidence This was not a clinical trial and did not involve patients as such the level of evidence was Grade A: Consistent 1 and 2.

Metabolomic Profile of Young Adults Born Preterm

Prematurity is a risk factor for the development of chronic adult diseases. Metabolomics can correlate the biochemical changes to a determined phenotype, obtaining real information about the state of health of a subject at that precise moment. Significative differences in the metabolomic profile of preterm newborns compared to those born at term have been already identified at birth. An observational case–control study was performed at the University Hospital of Siena. The aim was to evaluate and compare the metabolomic profiles of young adults born preterm to those born at term. Urinary samples were collected from 67 young adults (18–23 years old) born preterm (mean gestational age of 30 weeks, n = 49), and at term of pregnancy (mean gestational age of 38 weeks, n = 18). The urinary spectra of young adults born preterm was different from those born at term and resembled what was previously described at birth. The Random Forest algorithm gave the best classification (accuracy 82%) and indicated the following metabolites as responsible for the classification: citrate, CH2 creatinine, fumarate and hippurate. Urine spectra are promising tools for the early identification of neonates at risk of disease in adulthood and may provide insight into the pathogenesis and effects of fetal programming and infants’ outcomes.

Pinpointing Patterns of Violence: A Comparative Genocide Studies Approach to Violence Escalation in the Ukrainian Holodomor

This article utilizes the case study of the 1930s Ukrainian Holodomor, an artificially induced famine under Joseph Stalin, to advance comparative genocide studies debates regarding the nature, onset, and prevention of large-scale violence. Fieldwide debates question how to 1) distinguish genocide from other forms of large-scale violence and 2) trace genocides as unfolding processes, rather than crescendoing events. To circumvent unproductive definitional arguments, methodologies that track large-scale violence according to numerically-based thresholds have substituted for dynamics-based analyses. Able to address aspects of the genocide puzzle, these methodologies struggle to incorporate cross-cultural contextual variation or elicit ripe moments for specific, real-time interventions. Demonstrating how genocide’s precise, changing dynamics can be mapped over its duration, I present and apply a new mixed methods methodology, affirming that historical cases can inform modern prevention efforts. By coding 1932–1933 Ukraine-specific correspondences to/from Stalin, I pinpoint the precise moment when genocidal intent and victim selection overlaps.

Crisis of meaning in connection with mental distress of a modern man

In contrast with the contemporary spirit, which directs a person towards their own needs, satisfactions, and desires, logotherapy views the person and its life as an assignment. Man is not an individual "for himself" (according to Freud, the main internal motivational force is "the will of pleasure" and "the will of power" according to Adler), but a being of sense or a being for someone or something. According to Frankl, the purpose is defined as tasks, which life sets us in a precise moment and in a precise situation. These are tasks requiring a responsible reaction and a specific realisation of values. Each of them is unique. Each individual is responsible for a task, and only he can respond to it in a responsible man-ner. In this sense, life can be seen as a chain, whose links are the tasks themselves. Each in-dividual is unique, with a unique goal in life, which consists of individual, equally unique tasks. The centre of logotherapy is future - tasks and meanings. The founder of logotherapy is Viktor E. Frankl, who was a doctor of medicine and doctor of philosophy, and a professor of neurology and psychiatry at the University of Vienna. The third psychotherapeutic school in Vienna - logotherapy - is based on a holistic approach to an individual, which means that it analyses a person on a physical, mental, and spiritual level. Spiritual dimension is, among others, a place of realisation of responsibility and freedom or space of realisation of actual possibilities and tasks. Existential crisis, exis-tential vacuum, and noogenic neuroses are issues and mental problems, which originate from the spiritual dimension. This means failing to perceive and failing in life as an assignment. The empirical part of the research, which is based on the psychometric instrument LOGO-test, performed on two hundred re-spondents, gave us the results that even 24 percent of respondents are in various mental distresses and seriously existentially endangered. The paper highlights the most problematic areas and causes for such mental distress. The COVID-19 pandemic only deepened and revealed this crisis of meaning.

Polymethyl Methacrylate Cure Time in Simulated In Vivo Total Knee Arthroplasty Versus In Vitro Conditions

Background: The present means of confirming the cure of intra-operative polymethyl methacrylate (PMMA) cement is to wait for the remainder cement to harden. To our knowledge, there is no available technique to determine the precise moment of cure for in-vivo cement beneath the tibial tray. This study uses a novel means to determine cement curing time in two environments. One environment represents the operating theater, and the other environment attempts to model cement conditions under the tibial tray during surgery.Materials and Methods: We determined the temperature-versus-time plot of cement curing using the following two temperature sensors: one in a simulated implanted tibial tray and another in the remainder cement. We performed 55 tests using dental methyl methacrylate cement mixed in the same ratio as the orthopedic cement. To simulate in vivo conditions, a simulated stainless-steel tibial tray was implanted on a cancellous bone substitute (Sawbones, Vashon Island, WA, USA) using standard cement technique and subsequently placed in a 90°F (32.2 °C) circulating water bath. We positioned a temperature sensor in the cement mantel and positioned a second sensor in a portion of the remaining cement. The temperature from both sensors was measured simultaneously, beginning at 5 mins after mixing and continuing for 20 mins. The first derivative of the temperature provided the precise curing time for each condition. We analyzed the results of 55 repeated experiments with an independent samples t-test. Results: With the described technique, we were able to accurately determine the moment of cure of the cement beneath the simulated tray. There was a mean difference between cure time of 5 mins and 26 s (p-value<0.001) between the two conditions. Conclusions: We validated that our technique was successful in determining the precise time to cure in two different environments.Level of Evidence: This was not a clinical trial and did not involve patients as such the level of evidence was Grade A: Consistent 1 and 2

THE DEITY AS A MOSAIC: IMAGES OF THE GOD XIPE TOTEC IN DIVINATORY CODICES FROM CENTRAL MESOAMERICA

In this article I argue that the graphic images of the gods in the divinatory codices are composed of signs of different semantic values which encode particular properties. All of them contribute to creating the identity of the god. However, these graphic elements are not only shared by different deities, but even differ between representations of the same god. Analyzing the graphic images of Xipe Totec, one of the best-studied deities and one of the oldest in Mesoamerica, I elaborate a hypothesis that the images of the gods in the divinatory codices were perceived by their authors as a mosaic of different properties, which at the same time were dynamic. Consequently, there was not even one “prototypical” representation of a single god, since possibly the identity of a god was defined precisely when composing his/her image with particular graphic signs, thus crystallizing some of his/her multiple properties, important at this precise moment.